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ISSN: 2320-5407 Int. J. Adv. Res.

6(10), 52-60

Journal Homepage: - www.journalijar.com

Article DOI: 10.21474/IJAR01/7970


DOI URL: http://dx.doi.org/10.21474/IJAR01/7970

RESEARCH ARTICLE

ARSENIC IN DRINKING WATER IN PAKISTAN AND ASSOCIATED HEALTH RISKS

Mehwish Niazi.
MSc (Zoology) University of Sargodha Sub-Campus Mianwali, Pakistan.
……………………………………………………………………………………………………....
Manuscript Info Abstract
……………………. ………………………………………………………………
Manuscript History This paper first reviews the arsenic nature, and its mobilization in
Received: 01 September 2018 environment. Arsenic is a significant element of earth crust and also in
Final Accepted: 03 October 2018 a human body. General sources of arsenic are air, food, cigarette smoke
Published: November 2018 and beverages. Being soluble in water it exists in ionic forms and
affects the humans who consume arsenic contaminated water. Its
effects are severe and long lasting. Pakistan is one of those countries
where most of the ground water is contaminated with arsenic. Different
organizations such as World Health Organization, International Agency
for Research in Oncology & International Agency for Research in
Cancer and the United States Environmental Protection Agency has set
up the maximum permissible value of arsenic in drinking water for
various countries. IARC has ranked arsenic a group 1 human
carcinogen which causes lung, bladder and urinary cancers. In Punjab
(Pakistan) 20% of population is exposed to over 10 g/L in drinking
water and 3% of population is exposed to over 50 g/L and in Sindh
36% of population is exposed to arsenic via drinking water. In Punjab
and Sindh drinking water is contaminated with arsenic above the
permissible value defined by World Health Organization (WHO), while
KPK is less affected. Baluchistan is almost safe from arsenicism.

Copy Right, IJAR, 2018,. All rights reserved.


……………………………………………………………………………………………………....
Introduction:-
Being universal element arsenic is present in abundance in earth’s crust and positioned as 20 th in earth’s crust, 14th in
seawater and characterized as 12th abundant element in human body. (Khan and Ho, 2011).Various natural
processes such as weathering reaction, biological activities, anthropogenic activities and volcanic emanations are
involved in mobilization of arsenic in environment (Toor and Tahir, 2008).Earth crust contains high level of
arsenic due to which arsenic can easily leach in to the underground water (Kaltreider et al., 2001).

Water is most fundamental element in life like oxygen without it we could die in few days. More than two thirds of
human body is comprised of water; brain consists of 95 % water while 82 % and 90 % water exists in blood and
lungs (Tareen et al., 2013). As Arsenic is soluble in water it subsists in two primary forms: arsenite (As+3) and
arsenate (As+5). Both these forms are toxic and have severe and long lasting effects to a wide variety of organisms
including humans also (Abbas and Cheema, 2015).

General sources of organic or inorganic arsenic exposure are air, food and beverages and fundamental source is
drinking water. International Agency for Research on Cancer (IARC) classified arsenic as human carcinogen of skin

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Corresponding Author:-Mehwish Niazi.
Address:-MSc (Zoology) University of Sargodha Sub-Campus Mianwali, Pakistan.
ISSN: 2320-5407 Int. J. Adv. Res. 6(10), 52-60

and lung, and it is attributed to cancer of digestive and urinary systems also (Chen; 1992). Humans are exposed to
arsenic via inhalation of dust particles and by ingestion through drinking water (Rich et al., 1996).

It is reported that arsenic concentration in well waters ranges from 0.01 to 1.82 mg/1, which is approximately
0.5mg/1 (Pershagen, 1981). It is reported that at some places in Punjab and Sindh province the level of arsenic in
drinking water is beyond the acceptable limit defined by World health organization (WHO) which is (10μg/L)
(Khattak et al., 2016). Arsenic is exposed to human population via ingestion of arsenic contaminated water, foods,
drugs, smoking, it exerts serious and prolonged effects on health (Singh et al., 2006).

Endothelial cell dysfunction, inflammation and angiogenesis are associated with cognitive dysfunction and these are
proposed mechanisms which cause Alzheimer‘s disease (Bryant et al ., 2011). Epidemiological studies are
conducted in different areas of the world, which revealed that arsenic exposure influences human health severely it
causes cancers of liver, lung, bladder, kidneys and also cause skin cancers include hyperkeratosis and hyper
pigmentation and it is also associated with neurological disorders such as amnesia and peripheral neuropathy,
diabetes and arteriosclerosis (Raschid-Sally, 2000).

Regional Status of Arsenic Exposure in Pakistan


It is difficult to quantify the people who are subjected to arsenic poisoning especially in those areas where geo-
chemical resources are limited. Estimations are extensive and based on four principles; (1) Frequency of recently
documented cases of arsenicosis (2) Probability of ingested concentrations surpassing 50 μ g/L (3) Number of
people living in arsenic exposed areas (4) Liable aptitude of region to mitigate/remediate against arsenic
contamination (Thakur et al., 2010).

Table No 1:-National level survey for Arsenic Contamination.


Province Total samples (No.) Arsenic conc. >10 g/L Arsenic conc. >50 g/L References
Field Lab Field Lab Field Lab
Punjab 31,693 4,611 32.5 31.4 10.0 9.0 Ramay et
al., 2007
Sindh 67,556 4,825 24.0 36.0 7.8 17.0 Ramay et al.,
2007
KPK 1,560 156 0.30 22.0 0.0 0.6 Ahmed et
al., 2004
Baluchistan 619 71 1.30 1.40 0.0 0.0 Ahmed et
al., 2004
Table - 1
It is commonly observed from this table that water of Punjab and Sindh is affected from arsenic and Khyber
Pakhtunkhwa (KPK) is less affected. Baluchistan is almost safe from arsenicism.

Punjab Province
Most populated province of Pakistan is Punjab where drinking water sources have been reported to contain Arsenic
concentration above the safe limit defined by WHO and 20% of population is exposed to Arsenic (Bahadar et al.,
2014).

District No. of Samples Source Arsenic conc. Ref


Layyah 250 Ground water 0-150 g/L Soomro et al., 2011
Faislabad 64 Ground water 9 g/L Hussain et al., 2016
Sheikhupura - Hand pump 65-70 g/L Abbas et al., 2014
Multan 75 Ground water >50 g/L Hagras, 2013
Muzaffargarh 49 Shallow water and >50 g/L Naqvi et al., 2013
ground water
Rahim Yar Khan - Rotor pump >20 g/L Mahar et al., 2015
Table - 2

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Sindh Province
Epidemiological investigations are conducted in Sindh to expose the severe health effects of arsenic. Their findings
revealed that 61-73 % population is exposed to severe and prolonged effects of arsenic on human population
residing on the bank of Manchar Lake (Kazi et al., 2009). The general population of 30 to 40 % living in Bobak
village near Manchar Lake are exposed to high levels of arsenic, which cause several dermal diseases such as skin
lesions and rough skin with black dots (Arain et al., 2009).

No of
Total Noof samples Arsenic
District Study Area Source Ref
samples showing conc.
arsenic
Thatta Ghulamula Ground water 75 10 81 g/L Arain et al., 2014
11 81 g/L
12 45 g/L
13 90 g/L
14 76 g/L
15 63 g/L
Khairpur Tube wells, hand 45 30 <10 g/L Arain et al., 2006
pumps and dug 9 25-50 g/L
wells 6 100-250 g/L
Tando Allah Yar Hand pumps, 107 82 10 g/L Majidano et al.,
electric pumps, open 37 200 g/L 2010
wells and dug wells 60 100 g/L
Matiari Pumps and Motor 85 22 50 g/L Uqaili, 2016
pumps 18 20 g/L
Table - 3

Khyber Pakhtunkhwa (KPK) Province


District Source Arsenic.conc Ref
Mardan Ground water, Tap water >10 micro g/L Khattak
et al.,2016
Sawat Ground water, shallow 0.2 micro g/L Alam et al.,2008
water
Table - 4

Health Problems with Arsenic in Drinking Water


Arsenic in drinking water is ranked as a known human carcinogen by International Agency for Research of
Oncology (IARO) and it cause skin, bladder and lung cancer. (Memon et al., 2014). Most of the human population
is exposed to arsenic through ingestion, inhalation and through skin contact. Chronic respiratory diseases are caused
by most of the lung carcinogens but few studies revealed that the population exposed to arsenic has non-malignant
respiratory effects, but few studies reported high-risk assessment (Ehrenstein et al., 2005). Lung tumors, which are
caused by arsenic exposure, show different genetic and epigenetic modifications when compared with the studies on
individuals, which were living in arsenic free environment. Only inorganic arsenic is not involved in molecular
alterations in arsenic -induced tumors but the product which are produced in arsenic metabolism play major role in
such alterations (Hubax et al., 2013). It is estimated that the rate of mortality from lung cancer by consuming
arsenic contaminated water is higher than that of lung bladder and kidney cancers including cardiovascular diseases
(Smith et al., 2009).

Exposure of Arsine (AsH3) causes anemia due to massive intravascular hemolysis. Changes in sodium and
potassium levels act as earliest indicators of erythrocytes impairment (Chabowska et al., 2002). It is reported that
arsenic-induced apoptosis is induced as a result of over expression of BCR-ABL gene in human lymphoblast cells.
Arsenic as a tumor causing agent and it is selective in inducing apoptosis in promyelocytic leukemia cells. It is
studied that arsenic induces modifications in other signaling pathways via apoptosis (Tchounwou et al., 2003).

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Arsenic was characterized as a first chemical agent, which cause liver disease in humans. Chronic exposures of
arsenic over periods of months and years cause accumulation of arsenic in liver and badly affect the hepatic system
(Clarkson et al., 1991). Hyperkeratosis, hyper pigmentation and respiratory complications due to ingestion of
arsenic in drinking water stimulate changes in hormonal and mucosal immune response (Luqueno et al., 2013).
The chronic arsenic exposure cause skin de pigmentation which results in white spots that looks like rain drops, this
condition is medically described as leukomelanosis (Singh and Kumar; 2012). It is estimated that high arsenic
exposure via drinking water into young children aged less than 20 years (RR=10.6, 95% CI 2.9-39.2, p<0.001)
suffered from liver cancer and become target of mortality (Tantry et al., 2015). When arsenic is present in arsenate
and arsenite ionic form these ions replaces the phosphate ions and thiol group in cell and disrupt the normal
functioning of cells (Shahid et al., 2015). High levels of arsenic ingested by pregnant women exerts serious effects
on reproductive and developmental systems, arsenic can cross the placental barrier and cause miscarriages, low-birth
weight deliveries, and neonatal and postnatal mortalities (Lubin et al., 2007). Arsenic may affect internal organs,
impair their normal functioning without causing any visible external symptoms, and become difficult to recognize.
Hair, nails, urine and blood can be indicators of arsenic exposure before the external appearances (Petrusevski et
al., 2007).Arsenic affects children at higher rates because the symptoms are difficult to recognize at early (Bhatia et
al., 2014).

System Effects Ref


Cardiovascular Myocardial depolarization and cardiac arrhythmias, McCarty et al., 2011
system hypertension and atherosclerosis.
Blood forming Intravascular hemolysis, Erythrocytes impairment and Pakulska et al., 2006
System anemia.
Respiratory system Lung tumors and bronchial epithelial cell malignant Wang et al., 2011
transformation.
Nervous system Polyneuropathy, EEG abnormalities and, in extreme cases, Rodri et al., 2003
hallucinations, disorientation and agitation.
Dermal system Melanosis (diffuse and spotted), keratosis of palm and sole Khan et al., 2003
(spotted or diffuse), leukomelanosis (rain drop pigmentation),
and hyperkeratosis.
Renal system Protein urea, oliguria, mitochondrial damage in tubular cells Saha et al.,1998
Hepatic system Liver enlargement and hepatic fibrosis Guhamazumder, 2008
Table - 5

Figure 1:-Keratosis of palm and sole (spotted or diffuse)

Role of Metabolism of Arsenic in its Toxicity


Two main types of reactions take place in Arsenic metabolism: (a) Pentavalent arsenic goes reduction reactions and
convert into trivalent arsenic and (b) In oxidation reaction. These trivalent forms of arsenic are successively
methylated to form mono, di and trimethylated products by using S- adenosyl methionine which act as methyl
donor and glutathione (GSH) act as a co-factor (Pritchard, 2007). After ingestion, transition from blood into tissues
arsenate undergoes reduction reaction and reduced to arsenite. In Liver, arsenic undergoes methylation reaction and
methylated to form mono-methylated arsenic acid (MMAV), which further reduced to form mono-methyl arsenous

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acid (MMA III). This is converted into dimethyl-arsenic acid (DMA V) through a series of methylation reactions. In
this process of methylation, some reactive oxygen species (ROS) are formed (Lee et al., 2010). Arsenic metabolism
is followed by methylation process because methylated arsenic is excreted fast and easily than inorganic arsenic
(Rossman, 2003).

Figure - 2

Figure-2 showing the metabolism of arsenic in which arsenate is reduced to arsenite and methylated to form
pentavalent and trivalent forms of arsenic, dimethyl arsenic acid and dimethyl arsenous acid and trimethyl oxide are
also generated. Enzymes involved in reaction are GSH, reduced glutathione; GSTO1, glutathione S-transferase
omega-1; SAM, Sadenosylmethione;SAH, S-adenosylhomocysteine; AS3MT, arsenic methyltransferase(Cyt 19)
(Ebele, 2009).

Worldwide Extent of Arsenic Problems


The maximum acceptable levels of dissolved arsenic in drinking water are 0.01mg/l and 0.05mg/l according to the
World Health Organization and the United States Environmental Protection Agency, respectively. Several countries
in the world have identified excess amount arsenic in drinking water including Argentina, Bangladesh, Chile, China,
Hungary, India, Japan, Mexico, Mongolia, Poland, Taiwan, and the United States (Khalequzzaman et al., 2005).
Most of the countries have found that their waters are contaminated with arsenic due to mining wastes; countries
included Korea, Poland and Brazil. It is estimated in 2001 that approximately 130 million people are exposed to
arsenic concentrations beyond the 50 μ g L−1 (Halem et al., 2009).

Table 6:-Showing three Arsenic affected countries with Maximum approved parameter for Arsenic concentration in
drinking water defined by WHO.
Countries Maximum Approved parameter References
Pakistan 50 μ g L−1 Rahman et al., 2009
Bangladesh 50 μ g L−1 Naidu et al., 2006
USA 10 μ g L−1 Shakoor et al., 2015
Table – 6

In 1988, the EPA documented that continuing ingestion of arsenic 50 μ g /L-1 results in skin cancer rate of 1 in 400
in US, in 1992 EPA assessed that mortality risk of internal cancer is approximately 1.3 in 100 at 50 μ g/L. In 1999,
NRC reported that overall cancer mortality risk is approximately 1 in 100 at 50 g/L (Talibi et al). IARC have been
classified arsenic as a group 1 human carcinogen and toxic agent which also cause a wide variety of other diseases
except cancer and almost every part of internal system of human body is disturbed through arsenic (Naujokas et al.,
2012). Most of the ground and surface water of Pakistan has exceeded the level of heavy metals defined by WHO
(Gilani et al., 2013). According to a British Geological Survey study in 1998 on shallow tube-wells in 61 of the 64
districts in Bangladesh, 46% of the samples were above 0.010 mg/L and 27% were above 0.050 mg/L. When
combined with the estimated 1999 population, it was estimated that the number of people exposed to arsenic
concentrations above 0.05 mg/l is 28-35 million and the number of those exposed to more than 0.01 mg/l is 46-57
million (BGS, 2000). The US EPA suggested that by lowering the arsenic standard from 50 to 10 μ g/L could reduce

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the mortality rate which is due to skin, lung and bladder cancers and from heart diseases (Kapaj et al., 2006).

Conclusion:-
It is derived that Arsenic is an element, which is hazardous to health mainly in ionic form in water. It influences
human health mainly by the consumption of water. There are many countries in the world where drinking water has
exceeded the maximum permissible level of arsenic defined by World Health Organization (WHO). Arsenic is a
toxicant as well as a potent carcinogen which causes the lungs, urinary and bladder cancers. Pakistan is affected with
arsenicism specifically Punjab and Sindh provinces. Drinking water of Lyyah and Faislabad districts of Punjab is
badly affected. Ground water of Khairpur and Thatta (Sindh) have maximum concentration of Arsenic. KPK is less
affected and Baluchistan has shown no arsenic concentration in experimental water samples.

Abbreviations:-
WHO: World Health Organization
E PA: Environmental Protection Agency
NRC: Nature Reviews Cancer
IARC: International Agency for Research in Cancer
IARO: International Agency for Research in Oncology

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